在“2018深圳心力衰竭国际发展论坛暨心力衰竭治疗研讨会·深圳站”会议上，来自延世大学元州医学院的Yoo Byung Su教授为我们带来了"How hospitalization can be used for the optimization of heart failure drug and device therapy（如何利用住院治疗优化心力衰竭药物和设备治疗）"的精彩报告。

 

 

Outlines

 

• Background

• Key component of optimized HF management during hospitalization

• Device implantation

• Summary

 

Population aged 65 and older

 

Projected prevalence of HF in USA and Korea

 

Increasing Prevalence, Hospital Admission and Cost

 

The majority of healthcare costs for HF patients in Korea was related to hospitalization

 

Heart Failure (HF) is a Disease of High Mortality – Korean HF Registry Data

 

Predictors of In-hospital Mortality

 

Validation of the MAGGIC HF risk score for predicting mortality : similar result 

 

Post-discharge, the prognosis is poor

 

Mortality is particularly high in the early phase after hospitalization

 

Rehospitalization is particularly high in the early phase after hospitalization:

 

The burden of HF each hospitalization = start of a new vulnerable phase

 

Hospitalization is the key moment to optimize treatment

 

Hospitalization is the key moment to optimize treatment

 

Optimize heart failure care--from hospital discharge to patient follow-up

 

Several Organization for PM

 

ACCF/AHA/AMA-PCPI 2011 HF Performance Measures:  Inpatient

 

ACCF/AHA/AMA-PCPI 2011 Performance Measures: Outpatient

 

Reality: Use of evidence based medication in hospitalized patients

 

rug adherence and outcomes in hospitalized patients with HFrEF

 

SUrvey of Guideline Adherence for Treatment of Hospitalized Systolic Heart Failure Patients  in Real World (SUGAR)

 

Clinical Outcomes : De novo HF vs. ADHF

 

Clinical Outcomes and Discharge Medication as Guideline Adherence Indicator (GAI)

 

Early post-discharge assessment is key: further adjustments to therapy will be required

 

Hospitalization is the key moment to optimize treatment to prevent post-discharge mortality and rehospitalization

 

Major Trials of ICD for 1° Prevention

 

ICD implantation per million inhabitants in European country

 

ICD implantation in Asia

 

ICD & CRT in Korea

 

Disparity Between Indications for and Utilization of Implantable device in Asian Patients With Heart Failure.

 

Long-Term Prognosis of Patients with an Implantable Cardioverter-Defibrillator in Korea

 

CRT Response Rate in Korea

 

ICD Indication and Mortality

 

Analysis of Possible Candidates for ICD

 

IDC implantation vs. Outcomes

 

IMPROVE HF Patient Process Measures

 

ACCF/AHA/AMA-PCPI 2011 Performance Measures: Outpatient -- inpatient in Asia

 

Impact of the Improve the Use of Evidence-Based Heart Failure Therapies

 

Incremental Benefit with HF Therapies(Cumulative % Reduction in Odds of Death at 24 Months Associated with Sequential Treatments)

 

New Horizon

 

Trends in the Rate of Sudden Death across Trial Groups over Time

 

Ongoing Prospective Study in Korea

 

Conclusions